End-of-life planning depends on socio-economic and racial background: evidence from the US Health and Retirement Study (HRS)

Martina Orlovic, Haider Warraich, Douglas Wolf and Elias Mossialos

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: Context: Americans express a strong preference for participating in decisions regarding their medical care, yet they are often unable to participate in decision-making regarding their end-of-life care. Objective: To examine determinants of end-of-life planning; including, the effect of an individual's ageing and dying process, health status and socio-economic and racial/ethnic background. Methods: US observational cohort study, using data from the Health and Retirement Study (1992 – 2014) including 37,494 individuals. Random-effects logistic regression analysis was used to examine the relationship between the presence of a living will and a range of individual time-varying characteristics, including time to death, and several time-invariant characteristics. Results: End-of-life planning depends on several patient characteristics and circumstances, with socio-economic and racial/ethnic background having the largest effects. The probability of having a living will rises sharply late in life, as we would expect, and is further modified by the patient's proximity to death. The dying process, exerts a stronger influence on end-of-life planning than does the aging. Conclusions: Understanding differences that increase end-of-life planning is important to incentivize patients’ participation. Advance planning should be encouraged and accessible to people of all ages as it is inevitable for the provision of patient-centered and cost-effective care.

Keywords: advance care planning; end-of-life; end-of-life planning; living will (search for similar items in EconPapers)
JEL-codes: N0 (search for similar items in EconPapers)
Pages: 9 pages
Date: 2021-12-01
New Economics Papers: this item is included in nep-age, nep-hea and nep-isf
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Published in Journal of Pain and Symptom Management, 1, December, 2021, 62(6), pp. 1198 - 1206. ISSN: 0885-3924

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